Document Detail


Prognosis following first acute myocardial infarction in Type 2 diabetes: a comparative population study.
MedLine Citation:
PMID:  12060055     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: To estimate the incidence of death and macrovascular complications after a first myocardial infarction for patients with Type 2 diabetes. RESEARCH DESIGN: In a retrospective, incidence cohort study in the Tayside Region of Scotland we studied all patients hospitalized with a diagnosis of first acute myocardial infarction from 1 April 1993 to 31 December 1994. The primary endpoint was time to death. Secondary endpoints were 2-year incidence of hospital admission for angina, myocardial infarction, stroke, heart failure, coronary angiography, coronary artery bypass graft (CABG) and percutaneous transluminal coronary angioplasty (PTCA). RESULTS: The 147 patients with Type 2 diabetes had significantly worse survival with an increase in relative hazard of 67% compared with non-diabetic patients. After adjustment for age, sex, smoking status, prior heart failure, prior angina, delay to hospitalization, site of infarction, drug therapy with aspirin, beta-blockers, streptokinase and hyperlipidaemia and treated hypertension, Type 2 diabetes was still associated with a 40% higher death rate compared with people without diabetes (P < 0.05) There was no significant difference in death rates in those aged over 70 years, but an indication of a trend in younger individuals with a four-fold increase in death rate in those with diabetes aged < 60 years, compared with a rate ratio of 2.6 in those with diabetes aged 61-70 years. CONCLUSIONS: Among hospitalized patients with first acute myocardial infarction, Type 2 diabetes mellitus is consistently associated with increased mortality and increased hospital admission for heart failure. The estimated 4-year survival rate is only 50%. Our results indicate that younger subjects with Type 2 diabetes and acute myocardial infarction are a high-risk group deserving of special study, and support the argument for aggressive targeting of coronary risk factors among patients with Type 2 diabetes.
Authors:
P T Donnan; D I R Boyle; J Broomhall; K Hunter; T M MacDonald; R W Newton; A D Morris
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Diabetic medicine : a journal of the British Diabetic Association     Volume:  19     ISSN:  0742-3071     ISO Abbreviation:  Diabet. Med.     Publication Date:  2002 Jun 
Date Detail:
Created Date:  2002-06-12     Completed Date:  2002-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8500858     Medline TA:  Diabet Med     Country:  England    
Other Details:
Languages:  eng     Pagination:  448-55     Citation Subset:  IM    
Affiliation:
Medicines Monitoring Unit (MEMO), Department of Clinical Pharmacology, Diabetes Centre, and University Department of Medicine, Ninewells Hospital and Medical School, Dundee, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Cohort Studies
Diabetes Mellitus, Type 2 / complications*
Female
Humans
Hypertension / complications
Incidence
Male
Middle Aged
Myocardial Infarction / diagnosis,  epidemiology*,  mortality
Prognosis
Recurrence
Retrospective Studies
Risk Factors
Scotland / epidemiology
Smoking
Survival Analysis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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